| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT ROAD STE 800 ATLANTA, GA 30305 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $655 | $9K | 6.70% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INSURANCE BENEFITS INC. | 2500 NORTHWINDS PARKWAY ALPHARETTA, GA 30009 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $3K | $6K | 4.03% |
| NORMAC SOLUTIONS INC3 Filed as: NORMAC SOLUTIONS INC. | 3730 EVEREST DRIVE MONTGOMERY, AL 36106 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $581 | $3K | 1.98% |
| KLINGBEIL AND ASSOCIATES INC3 Filed as: KLINGBEIL AND ASSOCIATES INC. | 6000 LAKE FORREST DRIVE ATLANTA, GA 30328 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $339 | $1K | 0.97% |
| LAKIESHIA YEUVONNE MCGHEE3 | PO BOX 233 UNION CITY, GA 30291 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $75 | $1K | 0.87% |
| B V STONE INC3 Filed as: BV STONE INC. | 1800 SUNSET HARBOUR POINTE LAWRENCEVILLE, GA 30043 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $837 | $181 | $1K | 0.72% |
| CAROL PURDY FIELDS3 | 204 POTOMAC COURT WOODSTOCK, GA 30188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $885 | $38 | $923 | 0.66% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | PHIPPS TOWER SUITE 1100 3438 PEACHTREE ROAD ATLANTA, GA 30326 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $645 | $122 | $767 | 0.54% |
| LAURIE J BURNS3 | 303 PLYLER ROAD INDIAN TRIAL, NC 28079 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $517 | $176 | $693 | 0.49% |
| ROBYN EVETTE DAVIS3 | 59 ANDERSON AVENUE CANTON, GA 30114 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $565 | — | $565 | 0.40% |
| NORTH FLORIDA BENEFIT SOLUTIONS INC3 | 12659-1 PLUMMER GRANT ROAD JACKSONVILLE, FL 32258 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $438 | $42 | $480 | 0.34% |
| VINSON K ELLENBERG3 | 905 ADAIR AVENUE NE ATLANTA, GA 30306 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $427 | $32 | $459 | 0.33% |
| DANA MARIE MOWATT3 | 23701 S. WESTERN AVENUE #112 TORRANCE, CA 90501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $288 | $94 | $382 | 0.27% |
| ASSUREDPARTNERS3 Filed as: JENNIFER ROSE SMITH | 4920 W SAN RAFAEL STREET TAMPA, FL 33629 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $303 | $56 | $359 | 0.25% |
| EMLYN MARSTELLER IV3 Filed as: EMLYN H MARSTELLER IV | 412 SUGARLAND MEADOW DRIVE HERNDON, VA 20170 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $295 | $36 | $331 | 0.23% |
| MARIA VERONICA JARQUE3 | 8366 VIA SONOMA UNIT E LA JOLLA, CA 92037 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $269 | $54 | $323 | 0.23% |
| CAROLE H WARREN3 | 1300 27TH PLACE SOUTH BIRMINGHAM, AL 35205 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $239 | $80 | $319 | 0.23% |
| CRAIG ALEXANDER MILLER3 | 2037 POWERS FERRY ROAD SE MARIETTA, GA 30067 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $135 | $171 | $306 | 0.22% |
| TYLER HERRINGTON TORBETT3 | 2500 NORTHWINDS PARKWAY ALPHARETTA, GA 30004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $135 | $159 | $294 | 0.21% |
| DAVID A BETMAN3 | 4106 STOCONGA DRIVE BELTSVILLE, MD 20705 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $233 | — | $233 | 0.17% |
| MITCHELL HECTOR MORALES3 | 2825 WINDY HILL ROAD MARIETTA, GA 30067 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $169 | $37 | $206 | 0.15% |
| PLM SOLUTIONS INC3 Filed as: PLM SOLUTIONS INC. | 3244 WINTERBERRY CIRCLE MARIETTA, GA 30062 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $197 | — | $197 | 0.14% |
| SANTE CONCEPTS INC3 Filed as: SANTE CONCEPTS INC. | DBA SANTE CONCEPTS INC. ATLANTA, GA 31139 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $165 | — | $165 | 0.12% |
| KURT LOREN UNGLAUB3 | 221 WARREN AVENUE THOMASVILLE, GA 31792 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $33 | $85 | $118 | 0.08% |
| KATHERINE C ROBERTS3 | 8846 PICADILLY TRAIL OOLTEWAH, TN 37636 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $88 | $8 | $96 | 0.07% |
| BARBARA J LAKE3 | 226 N HIGH STREET MORRISTOWN, IN 46161 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $85 | $7 | $92 | 0.07% |
| WILLIAM T MILLER3 | 1500 PARKLAWN DRIVE CHARLESTON, SC 29414 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $88 | $3 | $91 | 0.06% |
| ASSURED BENEFIT SERVICES INC3 Filed as: ASSURED BENEFIT SERVICES INC. | STE 102 NEWNAN, GA 30263 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $66 | — | $66 | 0.05% |
| KIMBERLY FERGUSON3 | 4059 LOMAR DRIVE MOUNT AIRY, MD 21771 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $32 | $20 | $52 | 0.04% |
| THOMESE SCALES-BARANCO3 | 2203 HIDDEN CREEK DRIVE DECATUR, GA 30035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $43 | $3 | $46 | 0.03% |
| FELICIA FRANKLIN-WARNER3 | 10813 STARTLING TRAIL HAMPTON, GA 30228 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.03% |
| JAKORP INC3 Filed as: JAKORP INC. | 14458 CRESTWOOD AVENUE POWAY, CA 92064 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $20 | $20 | $40 | 0.03% |
| LILIENFIELD & ASSOCIATES LLC3 Filed as: LILIENFIELD AND ASSOCIATES, LLC | 1100 HIGGINS PLACE ROCKVILLE, MD 20852 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $16 | $38 | 0.03% |
| MAX MARTIN LINDSAY3 | 2911 STAGE RUN DRIVE HIXSON, TN 37343 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $25 | $37 | 0.03% |
| WILLIAM BENJAMIN KIRKLAND1 | 1899 ATKINSON BLVD. W PEARSON, GA 31642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $33 | $1 | $34 | 0.02% |
| TULLY AND COMPANY INC3 Filed as: TULLY AND COMPANY INC. | 1926 STONE BRIDGE LANE MARIETTA, GA 30064 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $30 | $3 | $33 | 0.02% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $20 | $10 | $30 | 0.02% |
| NORTH FLORIDA BROKER SOLUTIONS LLC3 | 1550 HARRINGTON PARK DRIVE JACKSONVILLE, FL 32225 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | $16 | $29 | 0.02% |
| DURWOOD BOOTH JR3 Filed as: DURWOOD BOOTH, JR. | 6231 HIGHAM DRIVE ALEXANDRIA, VA 22310 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $6 | $28 | 0.02% |
| L H FINANCIAL SERVICES INC3 Filed as: LH FINANCIAL SERVICES INC. | 6695 HIDDEN BROOK TRAIL COLLEGE PARK, GA 30349 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.02% |
| ANNALIESE CLARK3 | 1336 HIDEAWAY DRIVE S SAINT JOHNS, FL 32259 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18 | $5 | $23 | 0.02% |
| HOWARD HOROWITZ3 | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.02% |
| PAUL STANLEY JR3 Filed as: PAUL STANLEY JR, | 880 JOHNNY DODD BLVD MT PLEASANT, SC 29464 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $10 | $19 | 0.01% |
| JEFFREY D BRINDLE3 Filed as: JEFFREY BRINDLE | 10811 LAKEVIEW DRIVE CARMEL, IN 46033 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $4 | $16 | 0.01% |
| DORIS M KERCHNER3 | 1875 KERRY CREEK DRIVE MARIETTA, GA 30066 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.01% |
| HEATHER LEA HOOTEN3 | 7111 NE 222ND STREET MELROSE, FL 32666 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $5 | $10 | 0.01% |
| THE ADAMSON GROUP INC3 Filed as: THE ADAMSON GROUP INC. | 344 SUMMERSET DRIVE CHAPIN, SC 29036 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| INSURANCE MANAGEMENT SERVICES3 Filed as: INSURANCE MANAGEMENT GRP INC. | 1600 ST JULIAN PLACE COLUMBIA, SC 29204 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| ADVANCED BENEFIT SYSTEM INC3 Filed as: ADVANCED BENEFIT SYSTEM INC. | 1301 GERVAIS STRET COLUMBIA, SC 29201 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $4 | $7 | 0.00% |
| WILLIAM KYZER3 | PO BOX 8213 HERMITAGE, TN 37076 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| DAVID C BERRY3 | 1068 WILLOUGHBY LANDE MT PLEASANT, SC 29466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| CLAUDIA MARABOTO3 | 130 TIERRA MONTANOSA RANCHO SANTO MARGARITA, CA 92688 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| TIMOTHY J REED3 | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| BOBBY SCALES SR AND ASSOCIATES3 Filed as: BOBBY SCALES SR. AND ASSOCIATES | 6945 LANCASTER CIRCLE CUMMING, GA 30040 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| JUDITH C BARKSDALE3 | 6833 GLENLAKE PARKWAY SANDY SPRINGS, GA 30328 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JOHN D EVANGELISTA3 Filed as: JOHN D EVANELISTA | 29811 SANTA MARGARITA PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | PHIPPS TOWER SUITE 1100 3438 PEACHTREE ROAD ATLANTA, GA 30326 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 13.86% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SER | P.O. BOX 201503 GEORGIA LOCKBOX DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $756 | — | $756 | 1.14% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 444 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 444 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 170 | $66K |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 266 | $141K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.